Method and system for enabling interactive communications related to insurance data

ABSTRACT

A method of providing user interaction includes providing a processor and transmitting a communication from a first party to a second party. The method also includes posting, using the processor, an entry associated with the communication on a website, receiving a second communication from the second party to the first party, and posting, using the processor, a second entry associated with the second communication.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application is a continuation of 13/828,790, filed Mar. 14, 2013,issued Nov. 22, 2016 as U.S. Pat. No. 9,501,798 entitled “Method andSystem For Enabling Interactive Communications Related to InsuranceData” and claims priority to and the benefit of expired U.S. ProvisionalPatent Application No. 61/666,278 filed Jun. 29, 2012, entitled“Interactive Claims Wall,” which is incorporated herein by reference inits entirety. This application claims priority to U.S. ProvisionalPatent Application No. 61/666,278 filed Jun. 29, 2012, entitled“Interactive Claims Wall,” the disclosure of which is herebyincorporated by reference in its entirety for all purposes.

BACKGROUND OF THE INVENTION

Customers demand more of the products and services they use than everbefore. They insist that the companies they deal with on a regular basisprovide them greater and greater levels of accuracy and more tailoredservice offerings. Companies configure and operate ever increasingnumbers of computer systems to achieve this using sources of informationthat have traditionally been unavailable when servicing these customersis now expected.

SUMMARY OF THE INVENTION

The present invention relates generally to insurance systems. Morespecifically, the present invention relates to methods and systems forcommunicating between an insurer and the insured.

It is currently challenging for loss parties and member servicerepresentatives (MSRs) to communicate with one another. When a lossparty calls an MSR, the MSR is most often on the phone handling anotherloss. When the MSR calls the loss party, they are often not home. Theresult is a great deal of phone tag, voice mail and frustration.Existing electronic communication options are not supported on mobiledevices and not integrated with insurer's self-service application forclaims. Loss parties cannot receive or send electronic messages fromtheir smart phones or from within the context of existing mobile Claimsapplication. Accordingly, claims today can be settled at first notice ofloss or go on for years.

Members do not always know the claims process, what to expect, how andto whom they can turn for advice and guidance during the claim.

The longer a claim lasts, the harder it is for the member to maintaincontext as to what's been done, and what's left to do. There can bemultiple reps involved in a loss, including specialty reps, andco-workers pitching in to help a teammate. How can the member keep trackof whom to contact if they need help?

Embodiments of the present invention, which can, in someimplementations, be referred to as an Interactive Claims Wall, provide aone-stop record of all the back and forth communication between themember and the insurer. It's a secure portal for Social Media stylecommunication between MSRs and members regarding their claim that isintegrated with the insurer's mobile Claims application. The member canchoose any channel to communicate with the insurer, but allcommunication is captured on the Claims Wall, with context forchronology and who the parties are who are communicating. The ClaimsWall is available in any self-service channel. The insurer and themember can exchange documents, legal correspondence, photos and messagesall within context of the Claims Wall.

The member, also referred to as a customer, can send their ClaimsAdjuster an email and a reply can be made on behalf of the insurer byemail, with the entire email conversation being captured on the ClaimsWall. Embodiments of the present invention are not limited tocommunication between the insurer and the insured and can be extended toClaimants, vendors, body shops, attorneys, doctors, etc. The systemdescribed herein is well suited for portions of an insurer's businessthat interact with Case Management (i.e. Mortgage, Financial Planning,etc.). When information is posted on the Claims Wall (also referred toas the Wall), the Member will be notified by the method of theirchoosing (email, text, push notification).

According to an embodiment of the present invention, a method ofproviding user interaction is provided. The method includes providing aprocessor and transmitting a communication from a first party to asecond party. The method also includes posting, using the processor, anentry associated with the communication on a website, and receiving asecond communication from the second party to the first party. Themethod further includes posting, using the processor, a second entryassociated with the second communication on the website.

According to another embodiment of the present invention, a graphicaluser interface is provided. The graphical user interface includes afirst section including a listing of categories and a second sectionincluding a chronological list of communications. A subset of thecommunications are accessible by selection of one of the listing ofcategories.

According to a particular embodiment of the present invention, a methodof populating a Claims Wall is provided. The method includes providing aprocessor, identifying that an activity has occurred, and determining,using the processor that an automatic post is to be made. The methodalso includes determining, using the processor, a mode of communicationfor the post, transmitting information related to the post to a customerusing the mode of communication, and populating the Claims Wall with thepost.

According to an alternative embodiment of the present invention, asystem for receiving insurance data is provided. The system includes aprocessor and a network interface device configured to receive acommunication for a first party from a second party. The system alsoincludes a storage device configured to store the communication. Theprocessor is configured to determine a post for the first party. Thenetwork interface device is further configured to receive a secondcommunication for the second party. The processor is further configuredto determine a second post for the second party. The first user can bean insurance policy holder. The storage device can include a databaseand the database can include a table correlating posts to members of amembership organization. In an example, the first post appears on afirst Claims Wall and the second post appears on a second Claims Wall.

Numerous benefits are achieved by way of the present invention overconventional techniques. For example, embodiments of the presentinvention provide for increased efficiency in claims processing. Theseand other embodiments of the invention along with many of its advantagesand features are described in more detail in conjunction with the textbelow and attached figures.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a high level flowchart illustrating a method of providing userinteraction according to an embodiment of the present invention;

FIG. 2 illustrates a graphical user interface suitable for use withembodiments of the present invention;

FIG. 3 illustrates a graphical user interface suitable for use withembodiments of the present invention;

FIG. 4 illustrates a graphical user interface suitable for use withembodiments of the present invention;

FIG. 5 illustrates a graphical user interface suitable for use withembodiments of the present invention;

FIG. 6 illustrates a schematic diagram of a system for receivinginsurance data;

FIG. 7 illustrates a graphical user interface suitable for use withembodiments of the present invention;

FIG. 8 illustrates a graphical user interface for a mobile devicesuitable for use with embodiments of the present invention;

FIG. 9 illustrates a graphical user interface for a tablet devicesuitable for use with embodiments of the present invention;

FIG. 10 illustrates a graphical user interface for a mobile devicesuitable for use with embodiments of the present invention;

FIG. 11 illustrates a graphical user interface suitable for use withembodiments of the present invention; and

FIG. 12 illustrates a graphical user interface suitable for use withembodiments of the present invention.

DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS

Current claims processing systems are typically characterized by lengthyand inefficient communications processes. Embodiments of the presentinvention provide methods and systems in which multiple communicationmedia, including mobile phones, tablets, personal computers, and thelike can be used to communicate within the context of a loss that hasoccurred, whether the loss be an automobile loss, a property loss, orthe like.

Embodiments provide a Claims Wall that enables communication betweenmultiple parties, including the insurer, the insured, third partyservice providers, and the like. The communication can be related to thestatus of a claim, information related to the loss, including sharing ofdocuments, photos, links, and the like, to provide an improved claimsexperience. As an example, a post could be placed on the Claims Wallwhen an adjuster opens a loss matter, for example, introducing theconcept of the Claims Wall, which provides a virtual location in whichcommunication can occur in relation to the loss. The insured can respondto the post, which could be delivered to the adjuster or notify theadjuster of the response, could start a brand new conversation on theClaims Wall, which could be routed to the particular adjuster or anotherpredetermined party.

In some embodiments of the invention, any party that has a connection tothe claim may have access to a Claims Wall to provide an interface forthem to obtain and supply relevant information. Such parties mayinclude, but are not limited to: driver, passenger, owner, mortgagee,lienholder, tenant, contractor, repairman, property association,property manager, reporting person, police, fire, injured claimant,responsible person or company, witness, suspect, government office,manufacturer, moving and storage, expert, independent adjuster/staff,member, insurance company, insurance adjuster, insurance agent,attorney, attorney firm, public adjuster, guardian, employer, doctor orhospital. In yet other embodiments of the invention, parties with no orlittle connection with the claim may gain access to a Claims Wall toassist others in filing their claims; this may be particularly useful indisaster scenarios such as after hurricanes or other natural disasters.

As an example, processing of a loss event could be initiated either bythe insured placing a call to the insurer, initiating the processthrough a self-service channel, or other techniques for opening a claimfile. As discussed herein, opening of the claim file could result in anautomatic post to the Claims Wall, providing information to the insuredand requesting an information exchange process. In some implementations,the opening of the file is a trigger that initiates the posting to theClaims Wall. One of ordinary skill in the art would recognize manyvariations, modifications, and alternatives.

In a particular embodiment, the first post to the Claims Wall canprovide introductory information about the Claims Wall, explaining howinteraction is facilitated by the Claims Wall, including information onhow an insured person can post their questions on the Claims Wall,specify communications preferences, provide contact information such asa phone or fax number. When the loss begins to be processed by anadjuster, an additional automated post could be generated that providesan introduction to the adjuster and a notification to the insured thatthe claim file has been opened.

As described herein, the Claims Wall enables adjusters, other personnelassociated with the insurer, third parties, the insured, or the like toautomatically or manually post messages. When certain milestones arehit, messages can be posted automatically. Thus, in addition to theseinitial posts, automated posts can be provided throughout the life ofthe loss/claim, for example, when estimates are received and paymentsare issued, and when other significant milestones are hit, reducing theburden on the insurer to manually notify the insured with informationrelated to the loss.

Accordingly, the Claims Wall enables customer service representatives tocommunicate with the insured, for example, updating the insured on thestatus of a claim, without having to receive one or more phone calls andthen manually respond to questions from the insured. In an embodiment ofthe invention, the customer service representatives or MSRs may be ableto indicate that a message is sensitive, such that it is not sent to theuser via an insecure communications means such as e-mail. Thisindication may be made using a checkbox in the messaging interface, ormay automatically be triggered based on certain words or certain typesof attachments. In an embodiment, the member can only see sensitivemessages by accessing the Claims Wall via a secure interface such as anHTTPS internet connection.

FIG. 1 illustrates a flow diagram showing an embodiment of the inventionincluding a method for providing user interaction. The method includes astep for transmitting communication from a first party; posting an entryassociated with the communication on a website; receiving a secondcommunication from a second party; and posting a second entry associatedwith the second communication on the website. The first party may be aninsurance policy holder such as an insured driver, or a passenger of aninsured driver. The second party may be a claims adjuster working for aninsurance company or a membership organization. In other embodiments thetwo parties may be any number of other parties listed above in thedetailed description.

FIG. 2 illustrates another example of a Claims Wall on an insurer'swebsite. The Claims Wall illustrates

-   -   a) photo thumbnails attached by the member. Clicking on the        photo thumbnail would pull up the picture full size in a        separate window.    -   b) A member's comment to a claims adjuster's post.    -   c) A claims adjuster's post containing a link to other info on        website

FIG. 3 illustrates yet another example of a Claims Wall on an insurer'swebsite. The Claims Wall includes a document posted by Jan Smith claimsadjuster. (Typically, this would be a posting that is automated, butit's illustrated here to demonstrate that an adjuster can postdocuments). An automated post by the insurer that a payment has beenissued. An automated post by the insurer reminding the member that hehas To Dos.

FIG. 4 illustrates a Claims Wall with an initial wall post. Although theadjuster's name is illustrated, this can be an automated post and notindicate the adjuster's name.

FIG. 5 illustrates another version of the Claims Wall, which savesscreen real estate by not showing the text entry fields. If the userclicks ‘Start a New Conversation’ or ‘Reply or Attach’ button, a fieldwill display to type the user's comment/question.

FIG. 7 illustrates the Claims Wall after the user has clicked the ‘Replyor Attach’ button and is in the middle of typing a message. As indicatedin this example, there are only 13 characters remaining, although otherembodiments provide a greater data limit. Once the user clicks the Postbutton, the message will be posted and look similar to the post by JanSmith on April 16th at 3:45 pm. In other embodiments, there will be arecent post indicator and count. For example, every post newer thanseven days may have a recent indicator. The posts may automatically bereclassified as they age. In another embodiment, posts that the user hasnot seen before may be marked as new.

FIG. 8 illustrates an example of a Claims Wall on an iPhone.

FIG. 9 illustrates an example of a Claims Wall on an iPad. The pane onthe left shows my Conversations and the two most recent comments withinthat conversation. The pane on the right would not be seen in someembodiments. If the user taps anywhere on the conversation, the pane onthe right will slide on top of the left pane and the left pane wouldthen be hidden. The user could utilize this functionality when they wantto see the rest of the comments for that conversation.

FIG. 10 illustrates an example of a Claims Wall on an Android phone.Only the pane on the left would be visible with the conversations andonly the most recent comments for that conversation in the illustratedembodiment. If the user wants to see more, they would tap on theconversation (note: tapping on a thumbnail or PDF within a conversationwill launch the document not the additional comments in an embodiment)and the right pane would display with the rest of the comments for thatconversation.

FIG. 11 illustrates a Claims Work List that according to an embodimentof the present invention. As illustrated in FIG. 11, the. Claims WorkList shows the MSR two items in yellow getting ready to approach a 6hour service level objective and three items that are over 6 hours old.In other embodiments, different timing thresholds are utilized in theClaims Work List.

FIG. 12 illustrates a user interface that may be used by a claimsadjuster, a claims representative or an MSR in an embodiment of theinvention. The view may include a summary of the representative wall, ora summary of all the walls for the various parties that walls areavailable for, including extracts from posts by those parties as well asposts by the representative. The interface may also expose otherinformation relating to the claim.

In order to facilitate automatic notifications, embodiments of thepresent invention provide for a preference specification process inwhich the insured can specify how the insured would like to be notified,for example, by e-mail (which can be a default setting), by textmessage, push notifications to/from their mobile devices, or the like.As an example, if a person has specified a preference for email, anotification can be sent indicating that content has been posted ontothe Claims Wall. In some embodiments, only a notification is sent,whereas in other embodiments when content is posted on the wall, some orall of the content can be sent to the specified e-mail account(s),enabling the insured to receive information without logging into awebsite and viewing the Claims Wall. Over time, the Claims Wall willinclude some or all of the interactions that are occurring between theinsurer and the insured.

In some cases, information is confidential and content will be flagged,for example, by a customer service representative, so that thisconfidential information will not be posted on the Claims Wall, or willbe posted in a manner so that portions or all of the confidentialinformation will only be viewable by parties with appropriate accessrights. Ease of use is provided for the vast majority of communicationsthat don't require the security, while allowing a user to log in behindthe firewall for those communications that may have some sensitiveinformation included in or in conjunction with the content.

In insurance applications, there are some documents that, for example,by regulation or policy, cannot be delivered in an insecure environmentsuch as e-mail. For such documents, posting of the document on theClaims Wall could result in an e-mail message with a link that wouldenable the user to log into a secure site, for example, behind afirewall, where the documents could then be viewed on the Claims Wall.Even for documents with relaxed security, links can be provided to guidethe user to Claims Wall to view the document or other documents ofinterest. For some documents, portions of the information may be secureand only available after login, whereas other portions can be includedin the e-mail including the link to the secure site.

Tables 1-25 provide description related to triggers that result in thegeneration of a post, information included in the posts, and the variouschannels that can be used in relation to the posts. As illustrated, insome channels that are less data intensive (e.g., texts), links to datacan be provided rather than the data, which can be provided in channelswith greater data bandwidths (e.g., e-mail). One of ordinary skill inthe art would recognize many variations, modifications, andalternatives. The customer can specify a preferred channel or receiveinformation through multiple channels.

Tables 1-25 provides examples of posts that are suitable for use withthe Claims Wall. Embodiments of the present invention are not limited tothe particular wording utilized in these examples and other phrasing,triggers, and the like are included within the scope of the presentinvention. During use, changes can be made, new triggers added, and thelike. One of ordinary skill in the art would recognize many variations,modifications, and alternatives.

Thus, the examples described herein are not intended to limit thepresent invention but to merely provide examples of how, when a claim isinitiated, an automatic post to the Claims Wall can be generated by thesystem, thereby initiating formation of the Claims Wall.

As illustrated in Tables 1-25, a plurality of milestones during theclaims process can result in triggering of the system to generateautomated posts.

Although much of the content in a Claims Wall be communications betweenthe insurer and the insured, embodiments of the present invention arenot limited to these communications and other materials, includingdocuments related to a loss are include in the scope of the presentinvention. Additionally, in addition to the insured, other parties canbe provided with some or complete access to the Claims Wall or may havea separate Claims Wall (which can share overlap with the insurer-insuredClaims Wall). As examples, a claimant of the insured may have a wall, apassenger in a vehicle involved in an accident may have a wall, thirdparty providers, attorneys, medical personnel, investigators, or thelike. Thus, in general, a loss may have a plurality of walls accessibleto and showing differing information to multiple parties. The variousparties can view differing Claims Walls, for example, a claimant mayview certain items as opposed to the insured. The customer servicerepresentative may have a view of all items (i.e., a master ClaimsWall), with the other parties having a redacted set of items from themaster Claims Wall.

Although embodiments of the present invention are discussed in relationto insurance claims, the present invention is not limited to claims andcan be applied in other business environments.

As another example, during a catastrophe, a public wall scenario can beutilized in which persons involved with a catastrophe can post anddiscuss with others that are going through the same scenario, broadeningthe concept to communities of shared interest. For a particularinsurance company, a wall could be established for all insured livingwithin a predetermined vicinity of the catastrophe, with an automaticnotification enabling the insured to access information easily.

Embodiments of the present invention provide improvements incommunication not available using conventional techniques, for example,enabling a repair shop to post information on the status of the repairof a vehicle, with an automatic notification being generated to theinsured and/or the insurer upon posting or triggered by the posting.Thus, rather than relying on the insured to call the repair shop or aservice representative (who may have to call the repair shop), statusupdates can be provided with increased efficiency.

Embodiments of the present invention are not limited to a single wall,which can have subsets accessible and/or visible to different parties,but include a wall of walls, providing a hierarchy of informationcontent and display.

The Claims Wall provides, not only a place where various parties areable to communicate, but serves as a repository for communications anddocuments.

As an example, if a letter is sent by regular mail, the correspondencecan be digitized and placed on the Claims Wall. As another example, ifan email is sent through an e-mail channel, the email can be posted onthe Claims Wall, and a similar procedure can be applied to texts. Insome implementations, phone calls can be recorded and stored so thatthey are accessible via the Claims Wall, thereby providing a central hubfor all communications related to a claim.

Since events related to insurance can result in complicated claimsprocesses, the Claims Wall provides a system for an insured or otherparties to see the story of their loss as communications, documents, andthe like are organized so that the insured and insurer are able to seethe story and as it progresses over time. In one implementation,information can be ordered in a reverse chronological order. In anotherembodiment, the materials can be organized by category, for example,pictures and documents, which would be accessible by clicking on a linkthat would provide the user with a listing of pictures and documentsrelated to the claim. The data can be searchable, enabling a user tofind documents containing certain phrases, associated with certaindates, or the like. The posts can be grouped in threaded conversations,with conversations grouped in reverse chronological order in someembodiments and comments related to the conversation grouped togetherwith the related posts.

In some claims scenarios, specialists may handle certain claimsprocessing functions, resulting in the insured interacting with multipleentities at the insurer. Accordingly, conversations with differentindividuals can be separated so that the user can maintain a dialogueabout a first claims processing function (e.g., settling the total losson their vehicle) independent from another dialogue with a person thatis helping the insured with an injury. Communications and comments canthus be routed to the appropriate party in conjunction with posting onthe Claims Wall. In an embodiment, materials can be filtered byadjuster, providing a subset of the documents and conversationsassociated with the particular adjuster or set of adjusters.

Referring to FIG. 1, a first portion of the user interface provides aset of tabs, for example, photos and documents, and the like. Thevarious materials from the Claims Wall can be sorted and provided insubsets associated with the tabs.

Since some information can be confidential, materials posted on theClaims Wall can be categorized so that certain materials are availableto all parties and some materials are only available to certain parties.As an example, a medical bill can be visible to an adjuster and theinsured, but not to a passenger in the vehicle during the accident. Asanother example, the insured can see materials addressed to the insured,anything on which the insured was cc′ ed, and the like. The personoriginating the document can assign privileges to the document, enablingselected people to view the document or see that the document exists.Documents that are sent to the attorney for the insured will notnecessarily be available to the insured, conforming to certainrestrictions placed on communications with people that are representedby an attorney. Documents associated to minor children may be availableto parents, but not other family members that are not members of thehousehold, for example.

In an implementation, the adjuster has the ability to manually take adocument that is in the claim file and post it to the insured's wall. Inmulti-wall implementations, the adjuster can specify which of the wallsthe document should be posted. One of ordinary skill in the art wouldrecognize many variations, modifications, and alternatives.

For documents that are electronically filed by items and parties,automatic categorization can be performed to post the document to aClaims Wall for the party associated with the document. Thus, where thedocument is filed in an electronic records system can be used to decidewhether it would be an appropriate thing to post to a particular party'swall. Embodiments of the present invention enable certain comments orcertain documents to be displayed or not displayed depending on previoustagging of the document in the electronic records system.

In some insurance claims systems, a tree structure is used to describethe associations between all of the items and parties in the loss, forexample, the drivers of the vehicles involved in an accident, theattorneys for the drivers, the doctors for the drivers, and the like.Given this tree structure, each e-mail from a particular attorney canautomatically be categorized and then posted to the Claims Wall of theappropriate person automatically.

As discussed above, original posts to the wall can be created in anautomated manner when a file is opened, with the insured receiving, bydefault, an e-mail, but they can also specify in their preferences otherpreferred modes of communication. Depending on the kind of document orthe kind of information that's being uploading, a link or an actualdocument can be sent to the insured or other parties.

As materials including communications are sent, these materials canautomatically be included in a claim file and posted on the Claims Wall.When the insured posts something to the Claims Wall, a work item can besent to the appropriate adjuster and be tied to a loss number. Theclaims adjustor can follow that work item to the loss and a full versionof the Claims Wall. In one implementation, the full version of theClaims Wall will be accessible to the adjuster and will give theadjuster an option to post something to the Claims Wall, for example,adding their own documents. Additionally, the adjuster could forward thework item to a different adjustor if appropriate based on the content ofthe materials.

The Claims Wall can provide indications of the time that a work item hasbeen active, providing adjusters with an indication of the urgency withwhich items should be addressed. Initially, a work item with a four hourwindow could be shaded green, turning to a yellow color after an hour,indicating that the priority for action has been increased.Additionally, a notification bar can be provided that will notify theadjuster than various work items are ready to expire. As an example, ifa work item has expired after more than four hours in this example, theshading could be changed to red to further highlight the urgency to theadjuster. In another example, a work item type is provided for the wallpost that can include a ticking timer that indicates the time since thework item was posted to the wall, providing an adjuster with anindication of the urgency for responding to the item.

The Claims Wall can provide visual indications of timeliness, forexample, a conversation could be time-stamped and shaded with a color toindicate the urgency with which the conversation should be addressed. Asan example, items on the wall can change color so that the insured orthe adjuster can see the timeliness with which they should respond, forexample, a time within which a member should provide photos in responseto a request from an adjuster. If the materials are not provided in thetime requested, an automatic notification could be provided to themember to trigger their action. As another example, items can be flaggedto indicate an action item associated with the item. Recent posts can beindicated as recent for a predetermined period, for instance 120 hours.Posts can also be indicated as read or unread on the Claims Wall.

In an embodiment, a party can indicate an item on the wall and thenafter selection, send the item or supporting documents to a party suchas a repair shop, a doctor, an attorney, or the like. In otherembodiments, a third party such as an attorney or the repair shop can beinvited to see the Claims Wall. Other options can be provided includingprinting, image capture, and the like.

The Claims Wall can be integrated with a corporate correspondencesystem. In these implementations, when a letter is generated using thecorporate correspondence system, a copy of the letter could be placed onthe Claims Wall and accessible to the customer to which the letter wasaddressed. For automobile repair estimates, when an auto repair estimateis received from an appraiser, the estimate can be posted to the wall.Documents received in paper form can be digitized, for example a medicalreport, which could then be assigned a security classification andposted on appropriate walls while remaining invisible to parties notauthorized to view the medical report. A user interface associated withdigitizing the document could be used to specify which Claims Wall wouldreceive the medical report or other suitable documents. Accordingly, anadjuster can have the ability to either post a document on the ClaimsWall or may mark it so that it will only be posted on Claims Wallsaccessible to certain persons.

In addition to documents and communications, the Claims Wall can provideeducational content either independently or associated with particularcommunications and documents. These educational content can includetext, videos, audio, or the like and be used to explain difficultconcepts, such as how to sign two-party checks, holdback, the total lossprocess, or the like.

Accordingly, the Claims Wall can be used to push content to parties inorder to help explain difficult concepts and expose the claims process,which can be complicated. As an example, a timeline of the claimsprocess could be integrated with the Claims Wall, explaining where theinsured is in the claims process. As another example, when a complicatedportion of the process occurs, for example, the cutting of a two-partycheck, an automated post can accompany the notification of the check toprovide educational content related to the action. The educationalcontent can be provided either automatically or manually depending onthe particular application. As another example, when a vehicle is atotal loss, an automatic post can be generated providing educationalinformation about the total loss process. Thus, embodiments of thepresent invention provide significant advantages over FAQs that have tobe searched out and may not be relevant to the issue confronting theinsured or other third party. Here, the educational content can bedirectly tied to the issue that the insured needs or wants to address.

The communications path provided by the Claims Wall enables automationof interactions, for example, for total loss actions. When a vehicle isa total loss, the insurer receives a valuation on the vehicle, addsappropriate taxes and fees and makes an offer to the insured for thetotal loss. The insured can verify the information about the vehicle(e.g., the right year, make, model, mileage, etc.), accept the offer,and a payment be issued. The Claims Wall enables automation of thisprocess, including delivering the valuation and the offer to the insuredand allowing the insured to accept the valuation so that that wholeoffer and acceptance process is streamlined and automated. In aparticular implementation, a post and notification can be generated whenthe offer comes out, a link to the offer can be provided on the wall,the user can click the link to obtain information about the offer,options to accept or reject the offer can be provided, options toprovide feedback on the offer or modify the offer, or the like can befacilitated through the Claims Wall. In addition to this loss scenario,the wall can be used to interact with the insured about specificactivities occurring related to the claim. By clicking on a tab relatedto a rental vehicle, a post indicating that the insured is covered for arental vehicle can be available, enabling the insured to click on a linkto preferred providers, providing information about daily caps on therental reimbursement, or the like.

Interactions through the Claims Wall enable real-time chat in aparticular implementation. As an example, the presence of the adjustercould be indicated, providing the user with insight into whether theadjuster is available, on the phone, at their desk but not available, orthe like. The presence of the insured could also be indicated, forexample, whether the insured is logged onto the insurer's website, orthe like. Once the presence of both the insured and the adjuster isindicated, a real-time chat could be initiated, with the dialoguerecorded on the Claims Wall. During the messaging provided as part ofthe real-time chat, an indication that one of the parties is typing canbe provided to dynamically indicate the progress of the chat session. Inthese embodiments, when a user logs into their wall and is looking atthe Claims Wall, the system can determine if the representative oradjuster is available for a call or chat with the user. If therepresentative is available, an indication, such as a change in thecolor of the conversation can be implemented, a button could appear, anicon could be displayed, or the like to indicate the presence andavailability of the representative for real-time interaction. In asimilar manner, similar indications can be provided to the adjuster orrepresentative when the user logs into the insurer's website.Additionally, if the adjuster has an action item related to the user,the action item can be raised to a higher priority when the user isavailable.

In another example, the user can indicate availability for real-timeinteraction, which would take the adjuster for their claim out of thephone queue so that they are available to interact with the user aftercompleting their current task. Thus, interaction of the user with theClaims Wall can result in assignment of their adjuster to interactthrough a real-time interaction modality.

As an alternative, if the adjuster handling a particular claim is notavailable, the user can request that another adjuster that is available,with an adjuster selected based on ability and expertise in relation tothe claim.

In another embodiment, the user can send an e-mail to the insurerthrough conventional e-mail channels and these emails will be capturedon the Claims Wall. Thus, in addition to e-mails from the insurer to theinsured or third parties being captured on the Claims Wall, e-mailsthrough other channels can be routed to the Claims Wall.

When a user receives a notification that a post has been placed on thewall, the user could respond to that e-mail and it will post onto thewall. Thus, e-mails, regardless of channel, can be posted on the ClaimsWall to enhance the user experience.

The following table provides a listing of entities that could eitherhave Claims Walls or be able to access a Claims Wall associated withanother entity. The list is not intended to be exclusive and limitembodiments of the present invention, but to provide examples ofentities that can access information through the Claims Walls describedherein.

Member/Customer

Spouse

Insured driver

Insured passengers

Insured pedestrian

Claimants (driver, owner, passenger,

pedestrian)

Power of Attorney

Public Adjuster

Rental Car company

Appraiser

Direct Repair Company/Contractor

Attorney/Attorney Firm

Estate

Guardian

Responsible Person/Company

Witness

Suspect

Manufacturer

Moving & Storage

Other

Government Office

Expert

Lien Holder

Mortgagee

Property Association

Property Manager

Repairman

Tenant

Doctor

Employer

Heir

Hospital

Other insurance carrier

The following table provides an exemplary list of navigation bar linksand some details related to selection of these links. The list of linksis not intended to be exclusive and limit embodiments of the presentinvention, but to provide examples of links that can be used to group,sort, or organize information accessible through the Claims Wallsdescribed herein.

Navigation Bar link Details Claims Wall Comprehensive view ofconversations, uploaded documents, photos Claim Overview and LossDetails (type of loss, date of loss, etc.), Loss To Do List/Statusstatus, Wall Owner's To Do List Photos and Documents Filtered view ofphotos and documents posted to the wall Inspections Details ofInspection appointment Estimates PDF of Estimates posted to the wallRental Details of Rental (company, # of days allowed, # of days left)Medical Filtered view of medical related documents posted on the wallPayments List and Details of payments issued on Wall Owner's claim.Coverage Summary Policy/coverage information. Things to Know AboutGraphical representations f important things Your Claim specific to theclaim. Examples: How Direct Repair Program Works, how to resolve cashinga 2 party check, What do I need to resolve my Total Loss, etc.

In the embodiment illustrated in FIG. 1, links including some of thelinks in the table above are provided to enable grouping of subsets ofposts based on category, subsets of documents, sorting of posts, viewingof posts by various entities, or the like. The links are not limited tothe illustrated list but can include other links as appropriate to theparticular applications.

Clicking on Claims Contacts will provide information on personnelrelated to your claim, including primary adjuster, injury adjuster,total loss adjuster, or the like, providing you with the contact card ofeach of the adjusters on your claim. As the adjusters are assigned, anentry would be posted on the Claims Wall, with this information alsoaccessible from a tab such as the Claims Contacts. Access to the contactcards will provide a vehicle to contact the adjuster or other entityusing one or more communications techniques such as texting, email,phone calls, or the like.

Some embodiments of the present invention are suitable for presentinginformation related to a claim as described herein. As examples,interactions and information can be provided related to the followingcategories:

Conversation

Ask a member service representative (MSR) a question/answer a question(members are a type of customer in some embodiments)

Chat—presence for MSR, for member

Member ask for extension of rental days

Provide un-fielded additional details (e.g., SSN or other informationthat is not included in a field on one or more insurance forms). In someembodiments, materials from the wall can be pulled and incorporated intofielded forms.

Post to specific MSR (e.g., total loss rep) Allow the member to chooserecipient.

Forward content—email, text (reply)

MSR pick canned responses (templates)

Spell/grammar check for MSRs and Member

Reasonable character check (text limit)

Read/unread indicator for the member to know MSR read document and/orfor the MSR to know the member read the document

Read receipt—request read receipt (for MSR and Member)

Allow MSR to delete/edit a message (not the Member in some embodiments)

Removed by Insurer message for member when material is removed (maynotify member)

Date, time stamp, from/to

Auto reply to member when work item is re-assigned to a different MSR

Create a private sticky note that is posted on the wall—Insurer viewableonly in some embodiments and only viewable to other entities (e.g.,member, doctor, etc.) in other 10 embodiments

Auto initiate first message on wall

Allow an MSR or other entity to reassign a question/message to anotherMSR

Badge for new postings (e.g., a number indicator on a mobile device)(count of the number of messages that have not been read for Member)

“New” indicator on my accounts on the insurer's website (Either a “New”feature on the insurer's website or that the member has new postings onThe Wall)

See my new messages

Screen/filter for profanity, etc., for angry words

Allow options for new and reply messages

Save draft

Pend MSR post for Manager review and approval prior to posting on theClaims Wall.

“New” indicator on loss summary for The Wall message(s) (unread messagesexist)

“Set up alerts (push notification to the member, when I post to thewall)

This includes a short description of what was posted to The Wall.”

Post comment for a specific photo or document

Auto refresh for MSR view of The Wall

Documents

Upload document/photo (MSR and Member from all self-service channels)

View documents/photos on The Wall (MSR and member)

Scroll through photos e-sign document

View correspondence Give written statement Edit, submit, sign forms

Get forms (store standard forms on The Wall so the member can get tothem)

File submission in correct electronic folder (auto file documents andphotos)

Sign online agreement

Automatically post outbound correspondence (Letters—MSR and Systemgenerated)

From electronic records—expose/pull back electronic documents (edocs)

Status

information about critical milestones in the claim file/process

information related to status of insurer's tasks (inspection complete,payment issued, etc.)

repair status of vehicle

police report or other third party documents

claims process map indicating the current status and future action itemsfor the claim, which could be a tree structure with different beginningand end points

General Information/Links

Who is my claims representative (contact list of people handling orrelated to the claim)

“Provide access to the member's “To Do” tasks on The Wall

set up rental

set up appraisal”

Provide access to the member's policy from The Wall—to viewlimits/deductibles/benefits (link to the policy page the member sees onClaims Status)

ability to escalate post to a manager if it is marked as a complaint

schedule call back

provide electronic funds transfer information give recorded statement(e.g., audio)

Reconstruct accident

Catastrophe (CAT)—tell me what to do, where to go

See a map of CAT-related things—drive-ins

Link to a cat wall—post weather maps

Search (Find capability on a word/phrase)

See a calendar of key dates—appraisal, rental through, historicalactivities, due dates

Click on thumbnail to view doc/foinilphoto (selecting)

Give feedback/rating on doctor, MSR, PDRP

See previous reviews on providers

Where I am related to my coverage limits

Link to car buying—CRS, home circle, auto circle, providing informationwhen a vehicle or other property is a total loss

Marketing messages—eligibility check

Add “The Wall” to print claim file for legal discovery (need the abilityto print everything from The Wall—this may be manual for project 1)

Setup/Preferences/Personalization

set loss specific communication preferences—channel, times,address/phone

personalize page—photo, avatar, signature block

save as content to desktop/e-mail/cloud for instance (photos anddocuments) multiple tabs/views—photos only, timeline documents only

filter/sort list by type photo, doc, date, theme

Preferences of wall notifications—on/off, text, email (when certainthings happen)

Photo of MSR

Bookmarks, flag item or view bookmarked item

Access

allow attorney/spouse/etc. to see information (could be in addition tospousal access) allow spouse to post (or guardian, Power of Attorney, .. . )

view only access to The Wall for spouse/attorney invite bank MSR tooffer bank loan

invite life MSR to purchase annuity settlement

Communicate with provider

Link to provider wall

Combine wall for related losses (homeowner, UPP, auto . . . )

Restrict Wall if fatality, glass/tow due to low value of claims,lawsuit, member rejects, sym losses, or the like. Restrictions forposting can be defined based on fields associated with the loss.

Define access for various entities

Define access for materials present on the Claims Wall

Work Items

“Notify the member of a re-assignment or new split assignment

The Wall would be updated with the new MSR

Notifying the member of a new MSR or other updates from MSR's list oflosses—see new message indicator

Reporting Requirements

Keep track and be able to report counts on:

conversations started by customer

comments made by customer

customer posts that included photos or documents

conversations started by MSR

comments made by MSR

MSR posts that included photos or documents

Company posts that were automated

In some embodiments, creation of an electronic document by a claimsadjuster will result in automatic posting of the electronic document onthe Claims Wall. A member can view The electronic document, provides anelectronic signature through the Claims Wall, and the like. The postingscan be made automatically, manually, or the like. The content of thepost can be partly automated, can be partly filled in by the MSR, or thelike. During viewing of a message on the wall, the member can respond,which will both send the response to the MSR as well as result in aposting on the wall. Electronic signing by the member can result in aposting on the wall indicating the signature has been received. Thus,embodiments of the present invention provide a comprehensive treasury ofinformation including audio files corresponding to voice mails andtelephone calls and other media and information. Accordingly, a completerecord of all interactions related to the claim are provided in someembodiments.

If a notification is received that indicates that a claim has beenadjusted, an offer could be presented and posted on the wall. Thecustomer can then view the offer and indicate acceptance in aninteractive manner, typically using a form to accept the offer. Theacceptance can then be posted on the wall indicating the acceptance. Oneof ordinary skill in the art would recognize many variations,modifications, and alternatives.

In relation to the catastrophe information above, a Catastrophe Wall canbe built, with neighborhoods for which there is a high concentration ofmembers being added to provide information to affected members. A wallcould be created for the catastrophe, providing members in the vicinityof the catastrophe with relevant information such as the location of CAToperations, contact information, maps, or the like. Members livinginside the CAT area can be added to the wall in an automated manner ande-mail blasts or other messages can be sent notifying them of thepresence of the wall and building a sense of community.

In addition to insurance Claims Wall, embodiments of the presentinvention provide walls within walls, providing information onactivities in addition to insurance claims.

Embodiments of the present invention are not limited to use in insuranceclaims processing, but are also applicable to other business activities,including banking, financial services, stock and bond activities,medical systems, and other suitable business systems.

FIG. 6 is high level schematic diagram illustrating a computer systemincluding instructions to perform any one or more of the methodologiesdescribed herein. A system 600 includes a computer 610 connected to anetwork 230. The computer 610 includes a processor 620 (also referred toas a data processor), a storage device 622, an output device 624, aninput device 626, and a network interface device 628, all connected viaa bus 630. The processor 620 represents a central processing unit of anytype of architecture, such as a CISC (Complex Instruction SetComputing), RISC (Reduced Instruction Set Computing), VLIW (Very LongInstruction Word), or a hybrid architecture, although any appropriateprocessor may be used. The processor 620 executes instructions andincludes that portion of the computer 610 that controls the operation ofthe entire computer. Although not depicted in FIG. 6, the processor 620typically includes a control unit that organizes data and programstorage in memory and transfers data and other information between thevarious parts of the computer 610. The processor 620 receives input datafrom the input device 626 and the network 230 reads and stores code anddata in the storage device 622 and presents data to the output device624.

Although the computer 610 is shown to contain only a single processor620 and a single bus 630, the disclosed embodiment applies equally tocomputers that may have multiple processors and to computers that mayhave multiple busses with some or all performing different functions indifferent ways.

The storage device 622 represents one or more mechanisms for storingdata. For example, the storage device 622 may include read-only memory(ROM), random access memory (RAM), magnetic disk storage media, opticalstorage media, flash memory devices, and/or other machine-readablemedia. In other embodiments, any appropriate type of storage device maybe used. Although only one storage device 622 is shown, multiple storagedevices and multiple types of storage devices may be present. Further,although the computer 610 is drawn to contain the storage device 622, itmay be distributed across other computers, for example on a server.

The storage device 622 includes a controller (not shown in FIG. 6) anddata items 634. The controller includes instructions capable of beingexecuted on the processor 620 to carry out the methods described morefully throughout the present specification. In another embodiment, someor all of the functions are carried out via hardware in lieu of aprocessor-based system. In one embodiment, the controller is a webbrowser, but in other embodiments the controller may be a databasesystem, a file system, an electronic mail system, a media manager, animage manager, or may include any other functions capable of accessingdata items. Of course, the storage device 622 may also containadditional software and data (not shown), which is not necessary tounderstand the invention.

Although the controller and the data items 634 are shown to be withinthe storage device 622 in the computer 610, some or all of them may bedistributed across other systems, for example on a server and accessedvia the network 230.

The output device 624 is that part of the computer 610 that displaysoutput to the user. The output device 624 may be a liquid crystaldisplay (LCD) well-known in the art of computer hardware. But, in otherembodiments the output device 624 may be replaced with a gas orplasma-based flat-panel display or a traditional cathode-ray tube (CRT)display. In still other embodiments, any appropriate display device maybe used. Although only one output device 624 is shown, in otherembodiments any number of output devices of different types, or of thesame type, may be present. In an embodiment, the output device 624displays a user interface.

The input device 626 may be a keyboard, mouse or other pointing device,trackball, touchpad, touch screen, keypad, microphone, voice recognitiondevice, or any other appropriate mechanism for the user to input data tothe computer 610 and manipulate the user interface previously discussed.Although only one input device 626 is shown, in another embodiment anynumber and type of input devices may be present.

The network interface device 628 provides connectivity from the computer610 to the network 230 through any suitable communications protocol. Thenetwork interface device 628 sends and receives data items from thenetwork 230.

The bus 630 may represent one or more busses, e.g., USB (UniversalSerial Bus), PCI, ISA (Industry Standard Architecture), X-Bus, EISA(Extended Industry Standard Architecture), or any other appropriate busand/or bridge (also called a bus controller).

The computer 610 may be implemented using any suitable hardware and/orsoftware, such as a personal computer or other electronic computingdevice. Portable computers, laptop or notebook computers, PDAs (PersonalDigital Assistants), mobile phones, pocket computers, tablets,appliances, telephones, and mainframe computers are examples of otherpossible configurations of the computer 610. For example, otherperipheral devices such as audio adapters or chip programming devices,such as EPROM (Erasable Programmable Read-Only Memory) programmingdevices may be used in addition to, or in place of, the hardware alreadydepicted.

The network 230 may be any suitable network and may support anyappropriate protocol suitable for communication to the computer 610. Inan embodiment, the network 230 may support wireless communications. Inanother embodiment, the network 230 may support hard-wiredcommunications, such as a telephone line or cable. In anotherembodiment, the network 230 may support the Ethernet IEEE (Institute ofElectrical and Electronics Engineers) 802.3x specification. In anotherembodiment, the network 230 may be the Internet and may support IP(Internet Protocol). In another embodiment, the network 230 may be alocal area network (LAN) or a wide area network (WAN). In anotherembodiment, the network 230 may be a hotspot service provider network.In another embodiment, the network 230 may be an intranet. In anotherembodiment, the network 230 may be a GPRS (General Packet Radio Service)network. In another embodiment, the network 230 may be any appropriatecellular data network or cell-based radio network technology. In anotherembodiment, the network 230 may be an IEEE 802.11 wireless network. Instill another embodiment, the network 230 may be any suitable network orcombination of networks. Although one network 230 is shown, in otherembodiments any number of networks (of the same or different types) maybe present.

A user computer 250 can interact with computer 610 through network 230.The user computer 250 includes a processor 252, a storage device 254,and an input/output device 256. The description related to processor 620and storage device 622 is applicable to processor 252 and storage device254. As an example, the user computer 250 can be a personal computer,laptop computer, or the like, operated by a member of a membershiporganization (e.g., the present assignee). Using the user computer 250,the member can then interact with computer 610 operated by the presentassignee through network 230 in order to access the present assignee'sweb pages or the like.

The embodiments described herein may be implemented in an operatingenvironment comprising software installed on any programmable device, inhardware, or in a combination of software and hardware. Althoughembodiments have been described with reference to specific exampleembodiments, it will be evident that various modifications and changesmay be made to these embodiments without departing from the broaderspirit and scope of the invention. Accordingly, the specification anddrawings are to be regarded in an illustrative rather than a restrictivesense.

The attached Appendix provides additional description related toembodiments of the present invention, the disclosure of which is herebyincorporated by reference in its entirety for all purposes.

It is also understood that the examples and embodiments described hereinare for illustrative purposes only and that various modifications orchanges in light thereof will be suggested to persons skilled in the artand are to be included within the spirit and purview of this applicationand scope of the appended claims.

What is claimed is:
 1. A method of managing networked communicationsbetween a plurality of parties, the method comprising: electronicallyreceiving an indication of an insurance claim; generating a claim wallcomprising a website page and associated with the insurance claim,wherein the claim wall is configured to be output to a user interface asone or more entries, wherein the one or more entries are output in areverse chronological order on the user interface, and wherein each ofthe one or more entries is configured to display at least one commentassociated with the entry; providing access to the claim wall for aninsured party, an insuring party, and a third party service provider,wherein the user interface is configured to receive the at least onecomment associated with the entry from at least one of the insuredparty, the insuring party, and the third party service provider;generating a process map associated with the insurance claim, theprocess map including one or more tasks and one or more-service levelobjectives associated respectively with the one or more tasks; postingthe process map, including the one or more tasks and the one or moreservice level objectives, on the claim wall; identifying that anactivity has occurred, wherein the activity relates to a status changeof the one or more tasks; and populating the claim wall with statusinformation regarding the status change of the one or more tasks.
 2. Themethod of claim 1, the claim wall is accessible to at least one otherparty associated with the claim.
 3. The method of claim 2, whereinaccess to the claim wall is restricted to the insured party, theinsuring party, and the third party service provider.
 4. The method ofclaim 1, a portion of the claim wall is provided using a secureinterface.
 5. The method of claim 4, wherein the status informationincludes confidential information restricted to the secure interface. 6.The method of claim 1, further comprising identifying a different modeof communication according to a type of loss associated with theinsurance claim.
 7. The method of claim 1, further comprising: posting asecond entry on the claim wall.
 8. The method of claim 1, wherein thestatus information includes a voice call.
 9. The method of claim 8, thethird party service provider includes at least one of a doctor or anattorney.
 10. A method comprising: electronically receiving anindication of an insurance claim; generating a claim wall comprising awebsite page and associated with the insurance claim, wherein the claimwall is configured to be output to a user interface as one or moreentries, wherein the one or more entries are output in a reversechronological order on the user interface, and wherein each of the oneor more entries is configured to display at least one comment associatedwith the entry; providing access to the claim wall for an insured party,an insuring party, and a third party service provider, wherein the userinterface is configured to receive the at least one comment associatedwith the entry from at least one of the insured party, the insuringparty, and the third party service provider; generating a process mapassociated with the insurance claim, the process map including one ormore tasks and one or more service level objectives associatedrespectively with the one or more tasks; posting the process map,including the one or more tasks and the one or more service levelobjectives, on the claim wall; identifying that an activity hasoccurred, wherein the activity relates to a status change of the one ormore tasks; and populating the claim wall with information regarding thestatus change of the one or more tasks.
 11. The method of claim 10,further comprising: providing an agreement related to the insuranceclaim using the claim wall; receiving a network communication related tothe agreement; and electronically executing the agreement on behalf ofthe at least one of a party related to the insurance claim.
 12. Themethod of claim 11, the agreement relates to a payment for the insuranceclaim.
 13. The method of claim 11, the agreement relates to a rentalassociated with the insurance claim.
 14. The method of claim 11, theagreement relates to service associated with the insurance claim. 15.The method of claim 10, further comprising posting an entry related to amilestone related to the insurance claim on the claim wall.
 16. Anon-transitory computer-readable medium comprising instructions formanaging networked communications that cause a processor executing theinstructions to effectuate operations comprising: electronicallyreceiving an indication of an insurance claim; generating a claim wallcomprising a website page and associated with an insurance claim,wherein the claim wall is configured to be output to a user interface asone or more entries, wherein the one or more entries are output in areverse chronological order on the user interface, and wherein each ofthe one or more entries is configured to display at least one commentassociated with the entry; providing access to the claim wall for aninsured party, an insuring party, and a third party service provider,wherein the user interface is configured to receive the at least onecomment associated with the entry from at least one of the insuredparty, the insuring party, and the third party service provider;generating a process map associated with the insurance claim, theprocess map including one or more tasks and one or more service levelobjectives associated respectively with the one or more tasks; postingthe process map, on the claim wall including the one or more tasks andthe one or more service level objectives, on the claim wall; identifyingthat an activity has occurred, wherein the activity relates to a statuschange of the one or more tasks; and populating the claim wall withinformation regarding the status change of the one or more tasks. 17.The non-transitory computer-readable medium of claim 16, the insuranceclaim relating to a catastrophic cause.
 18. The non-transitorycomputer-readable medium of claim 17, further comprising generating acatastrophe wall available to parties in a catastrophe area, thecatastrophe wall including common information for a plurality ofinsurance claims including the insurance claim and catastrophe-relatedinformation.
 19. The non-transitory computer-readable medium of claim18, the catastrophe-related information including a catastrophe map,information about services available in the catastrophe area, andcatastrophe-specific contact information.
 20. The non-transitorycomputer-readable medium of claim 18, further comprising generating anadjuster view including a plurality of wall summaries.